Abstract 274: Primary Reasons Bystanders Do Not Perform CPR When Receiving Dispatcher Instructions
Introduction: Dispatch-Assisted CPR (DACPR) has been shown to be an effective method of increasing bystander CPR (BCPR) rates and survival from out-of-hospital cardiac arrest (OHCA).
Objective: No quantitative studies have specifically assessed why bystanders fail to perform CPR when offered pre-arrival CPR instructions from a dispatcher. We identified common reasons bystanders do not perform CPR when 9-1-1 emergency dispatchers offer CPR instructions.
Methods: Review of suspected OHCA audio recordings from 3 regional 9-1-1 emergency dispatch centers for calls in which dispatchers offered CPR instructions. This study evaluated the subset where callers either verbally refused or were unable to perform CPR. The reasons for refusal or inability to perform CPR were categorized and recorded on a structured data form.
Results: 555 total audio files between 04/11-01/12 were identified based upon dispatch center suspicion of OHCA. Upon review of calls, cases were excluded if: CPR was not indicated (111/555, 20.0%), CPR was already in progress (60/555; 10.8%), bystanders believed the victim to be deceased (59/555, 10.6%), audio was not clear (20/555, 3.6%), caller was not with victim (18/555, 3.2%) or EMS arrived before DACPR could be initiated (13/555, 2.3%). Bystanders performed CPR per dispatch instructions in 30.1% of cases (167/555). In the remaining cases (107/555, 19.3%; study group), BCPR was not performed because bystanders were either unwilling to perform CPR (58/107, 54.2%) or unable to attempt CPR (49/107, 45.8%).
Conclusion: There are multiple reasons bystanders do not perform CPR, even when dispatcher instructions are offered. In this study, inability to move the arrest victim, fear of causing harm, and panic were the predominant reasons CPR was not initiated. An assertive dispatcher can help overcome these barriers.
- © 2012 by American Heart Association, Inc.